The association between physical complications following female genital cutting and the mental health of 12-year-old Gambian girls: A community-based cross-sectional study.

Bothild Bendiksen,Trond Heir,Fabakary Minteh,Rex A Kuye,Mai Mahgoub Ziyada,Inger-Lise Lien,Kimiyo Kikuchi

doi:10.1371/journal.pone.0245723

Abstract

Female genital cutting (FGC) involve an acute physical trauma that hold a potential risk for immediate and long-term complications and mental health problems. The aim of this study was to examine the prediction of depressive symptoms and psychological distress by the immediate and current physical complications following FGC. Further, to examine whether the age at which 12-year-old Gambian girls had undergone the procedure affected mental health outcomes. This cross-sectional study recruited 134 12-year-old girls from 23 public primary schools in The Gambia. We used a structured clinical interview to assess mental health and life satisfaction, including the Short Mood and Feeling Questionnaire (SMFQ), the Symptom check list (SCL-5) and Cantril's Ladder of Life Satisfaction. Each interview included questions about the cutting procedure, immediate- and current physical complications and the kind of help and care girls received following FGC. Depressive symptoms were associated with immediate physical health complications in a multivariate regression model [RR = 1.08 (1.03, 1.12), p = .001], and with present urogenital problems [RR = 1.19 (1.09, 1.31), p < .001]. The girls that received medical help following immediate complications had a lower risk for depressive symptoms [RR = .73 (.55, .98), p = .04]. Psychological distress was only associated with immediate complications [RR = 1.04 (1.01, 1.07), p = .004]. No significant differences in mental health outcomes were found between girls who underwent FGC before the age of four in comparison to girls who underwent FGC after the age of four. Our findings indicate that the immediate and long-term complications following FGC have implications for psychological health. Only a minimal number of girls received medical care when needed, and the dissemination of health education seems crucial in order to prevent adverse long-term physical and psychological health consequences.

Highlights

Female genital cutting (FGC) consists of all procedures involving partial or total removal of external female genitalia or other injury to the female genitalia for cultural, religious or other nontherapeutic reasons
No significant differences in mental health outcomes were found between girls who underwent FGC before the age of four in comparison to girls who underwent FGC after the age of four
Our findings indicate that the immediate and long-term complications following FGC have implications for psychological health

Summary

Introduction

Female genital cutting (FGC) consists of all procedures involving partial or total removal of external female genitalia or other injury to the female genitalia for cultural, religious or other nontherapeutic reasons. The immediate medical complications of FGC include excessive bleeding, pain, genital tissue swelling, urine retention and problems with wound healing [5, 6]. Female genital cutting (FGC) involve an acute physical trauma that hold a potential risk for immediate and long-term complications and mental health problems. The aim of this study was to examine the prediction of depressive symptoms and psychological distress by the immediate and current physical complications following FGC. To examine whether the age at which 12-year-old Gambian girls had undergone the procedure affected mental health outcomes

Objectives

Methods

Results

Conclusion